目的 探討舒爾經(jīng)膠囊聯(lián)合黃體酮膠囊治療氣滯血瘀型月經(jīng)不調(diào)的臨床療效。方法 選取2022年11月—2024年11月秦皇島市婦幼保健院收治的116例月經(jīng)不調(diào)患者，按照隨機(jī)數(shù)字法將患者分為對(duì)照組（58例）和治療組（58例）。對(duì)照組患者口服黃體酮膠囊，100 mg/次，每日2次。治療組在對(duì)照組的基礎(chǔ)上口服舒爾經(jīng)膠囊，2粒/次，每日2次。兩組用藥4周為1個(gè)周期，共治療3個(gè)周期。觀察兩組的臨床療效，比較兩組中醫(yī)證候積分、血清性激素水平、月經(jīng)血量評(píng)分、生活質(zhì)量評(píng)分、血流動(dòng)力學(xué)相關(guān)指標(biāo)、血清炎性因子水平的變化情況。結(jié)果 干預(yù)后，治療組總有效率是96.55%，顯著高于對(duì)照組總有效率82.76%（P＜0.05）。治療后，兩組面色晦暗積分、頭暈眼花積分、經(jīng)色紫暗伴血塊積分、手足麻木積分均顯著降低（P＜0.05）；治療后，治療組面色晦暗積分、頭暈眼花積分、經(jīng)色紫暗伴血塊積分、手足麻木積分低于對(duì)照組，（P＜0.05）。治療后，兩組月經(jīng)失血圖評(píng)分（PBAC）評(píng)分、簡(jiǎn)明健康狀況調(diào)查量表（SF-36）評(píng)分較前顯著升高（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組的PBAC評(píng)分、SF-36評(píng)分升高（P＜0.05）。治療后，兩組搏動(dòng)指數(shù)（PI）、阻力指數(shù)（RI）較前降低，而子宮動(dòng)脈血流收縮期峰值流速（PSV）升高（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組RI、PI均較低，且治療組的PSV升高（P＜0.05）。治療后，兩組患者促卵泡生成素（FSH）、黃體生成素（LH）、雌二醇（E₂）、孕酮（P）水平較前升高（P＜0.05）；治療后，與對(duì)照組對(duì)比，治療組FSH、LH、P、E₂水平均升高（P＜0.05）。治療后，兩組內(nèi)皮素（ET）、白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）水平較前降低，而一氧化氮（NO）水平升高（P＜0.05）；治療后，治療組ET、IL-6、TNF-α水平低于對(duì)照組，NO水平高于對(duì)照組（P＜0.05）。結(jié)論 舒爾經(jīng)膠囊與黃體酮膠囊協(xié)同治療氣滯血瘀型月經(jīng)不調(diào)效果較佳，可較好地改善患者臨床癥狀，并能調(diào)節(jié)子宮血流動(dòng)力學(xué)指標(biāo)，提升患者生活質(zhì)量，值得借鑒與應(yīng)用。

Objective To explore the therapeutic effect of Shuerjing Capsules combined with Progesterone Capsules in treatment of menstrual disorders of qi stagnation and blood stasis type. Methods A total of 116 patients with menstrual disorders admitted to Qinhuangdao Maternal and Child Health Hospital from November 2022 to November 2024 were selected and divided into control group of 58 cases and treatment group of 58 cases according to the random number method. Patients in control group were orally administered Progesterone Capsules, 100 mg each time, twice daily. Patients in treatment group took Shuerjing Capsules orally on the basis of control group, 2 capsules each time, twice daily. Both groups were treated for 4 weeks as one cycle, and a total of 3 cycles were completed. The clinical efficacy of two groups was observed, and the changes in TCM syndrome scores, serum sex hormone levels, menstrual blood volume scores, quality of life scores, hemodynamic-related indicators, and serum inflammatory factor levels between two groups were compared. Results After intervention, the total effective rate of the treatment group was 96.55%, significantly higher than 82.76% of control group (P < 0.05). After treatment, the scores of dull complexion, dizziness and blurred vision, dark menstrual color with blood clots, and numbness of hands and feet in both groups were significantly reduced (P < 0.05). After treatment, the scores of dull complexion, dizziness and blurred vision, dark menstrual color with blood clots, and numbness of hands and feet in the treatment group were lower than those in the control group (P < 0.05). After treatment, PBAC scores and SF-36 score in both groups were significantly increased compared with those before (P < 0.05). After treatment, compared with the control group, the PBAC score and SF-36 score of treatment group increased (P < 0.05). After treatment, PI and RI in both groups decreased compared with before, but PSV increased (P < 0.05). After treatment, compared with control group, RI and PI in treatment group were both lower, and PSV in treatment group increased (P < 0.05). After treatment, the levels of FSH, LH, E₂, and P in both groups increased compared with before (P < 0.05). After treatment, compared with control group, the levels of FSH, LH, P, and E₂ in treatment group all increased (P < 0.05). After treatment, the levels of ET, IL-6, and TNF-α in both groups decreased compared with before, but the level of NO increased (P < 0.05). After treatment, the levels of ET, IL-6, and TNF-α in treatment group were lower than those in control group, but the level of NO was higher than that in control group (P < 0.05). Conclusion The combined treatment of Shuerjing Capsules and Progesterone Capsules for menstrual disorders of qi stagnation and blood stasis type has a better effect. It can effectively improve the clinical symptoms of patients, regulate the hemodynamic indicators of the uterus, and enhance the life quality of patients, which is worth learning from and applying

R984

河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃項(xiàng)目（20221621）